Hydroxyapatite/collagen composite graft for posterior lumbar interbody fusion: a comparison with local bone graft.
Hydroxyapatite/collagen composite graft for posterior lumbar interbody fusion: a comparison with local bone graft.
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DOI：
10.1186/s13018-021-02798-4
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发表时间：
2021-10-24
影响因子：
2.6
通讯作者：
Okawa A
中科院分区：
文献类型：
--
作者：
Yoshii T;Hashimoto M;Egawa S;Hirai T;Inose H;Okawa A
自体骨已用于后路腰椎椎间融合术（PLIF）。然而，收获自体骨移植物与供体部位并发症相关。我们之前开发了一种羟基磷灰石/胶原（HAp/Col）复合材料作为骨传导性人工骨，其特点是具有高度多孔的结构和海绵状弹性。本研究旨在探讨 HAp/Col 复合材料与骨髓抽吸物 (BMA) 作为 PLIF 移植物替代物治疗腰椎疾病的有效性。这项研究前瞻性地调查了接受一级 PLIF 的患者。为了进行椎间融合，插入了两个钛笼。在椎间间隙的一侧，移植了填充有 BMA 的 HAp/Col 复合材料，填充钛笼。另一方面，移植减压椎板切开术期间收获的局部骨移植物（LBG），然后使用椎弓根螺钉进行单层固定。目标水平为 L2/3 2 例，L3/4 3 例，L4/5 36 例，L5/S 5 例。我们评估了 46 名患者的临床症状和放射学结果，并将 HAp/Col 复合材料的融合状态与 LBG 的融合状态进行了比较。术后1年CT评估显示，HAp/Col中38例（82.6%）完全融合，而LBG中35例（76.1%）完全融合。 HAp/Col 和 LBG 之间没有统计学差异。 HAp/Col 中，不完全融合 5 名患者（10.9%），未融合 2 名患者（4.3%）；LBG 中，不完全融合 9 名患者（19.6%），未融合 2 名患者（4.3%）。手术后 2 年，HAp/Col 中完全融合的患者增加到 44 例 (95.7%)，LBG 中完全融合的患者增加到 41 例 (89.1%)。融合与非融合患者腰椎临床评分无显着差异。钛笼中含有 BMA 的 HAp/Col 复合材料可以有效地替代传统自体 LBG 进行椎间融合。试注册大学医院医学信息网，UMIN000045010，2021年7月30日，追溯注册，https://www.umin.ac.jp/english/。
Autologous bone has been used for posterior lumbar intervertebral fusion (PLIF). However, harvesting autologous bone graft is associated with donor site complications. We previously developed a hydroxyapatite/collagen (HAp/Col) composite as an osteoconductive artificial bone, characterized by having a highly porous structure with sponge‐like elasticity. This study aims to investigate the effectiveness of HAp/Col composite with bone marrow aspirate (BMA) as a graft substitute in PLIF for the treatment of lumbar spinal diseases. This study prospectively investigated patients who received one-level PLIF. For the interbody fusion, two titanium cages were inserted. On the one side of interbody space, HAp/Col composite incorporated with BMA filling the titanium cage was grafted. On the other side, local bone graft (LBG) harvested during decompressive laminotomy was grafted and then one-level instrumentation using pedicle screws was performed. The target levels were at L2/3 in 2 cases, L3/4 in 3 cases, L4/5 in 36 cases, and L5/S in 5 cases. We evaluated clinical symptoms and radiological outcomes of 46 patients and compared the fusion status of HAp/Col composite with that of LBG. The 1-year postoperative CT evaluation demonstrated that, in the HAp/Col, a complete fusion was observed in 38 patients (82.6%), whereas in the LBG, a complete fusion was observed in 35 patients (76.1%). There were no statistical differences between the HAp/Col and LBG. In the HAp/Col, incomplete fusion was observed in five patients (10.9%) and non-fusion in two patients (4.3%), and in the LBG, incomplete fusion was observed in nine patients (19.6%) and non-fusion in two patients (4.3%). At 2 years after the surgery, complete fusion increased to 44 patients (95.7%) in the HAp/Col and 41 patients (89.1%) in the LBG. There were no significant differences in the clinical scores for lumbar spine between patients with fusion and non-fusion. The HAp/Col composite with BMA in the titanium cage can be effectively used as an alternative to conventional autologous LBG for intervertebral spinal fusion. Trial registration University hospital Medical Information Network, UMIN000045010, July 30th, 2021, Retrospectively registered, https://www.umin.ac.jp/english/.
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影响因子：
3
作者：
Cunningham, BW;Kanayama, M;McAfee, PC
通讯作者：
McAfee, PC
DOI：
10.2106/00004623-199711000-00012
发表时间：
1997-11-01
影响因子：
5.3
作者：
Muschler, GF;Boehm, C;Easley, K
通讯作者：
Easley, K
影响因子：
2.8
作者：
Wei, Xuetao;Egawa, Satoru;Sotome, Shinichi
通讯作者：
Sotome, Shinichi
DOI：
10.1016/j.injury.2005.07.029
发表时间：
2005-11-01
影响因子：
2.5
作者：
Giannoudis, PV;Dinopoulos, H;Tsiridis, E
通讯作者：
Tsiridis, E
影响因子：
2.8
作者：
Maehara, Hidetsugu;Sotome, Shinichi;Okawa, Atsushi
通讯作者：
Okawa, Atsushi